Supervivencia en pacientes con cáncer de mama localmente avanzado tratadas con radioterapia posterior a mastectomía en el Instituto Nacional de Cancerología

Ospino, Rosalba; Cendales, Ricardo; Cifuentes, Javier; Sánchez, Zayda; Galvis, Juan; Bobadilla, Iván

doi:10.1016/S0123-9015(10)70084-6

Información del artículo

Resumen

Bibliografía

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Estadísticas

Resumen

Objetivo

evaluar los resultados del manejo de pacientes con cáncer localmente avanzado de mama tratadas con mastectomía y teleterapia en el servicio de radioterapia del Instituto Nacional de Cancerología entre los años 2003 y 2004.

Métodos

serie de casos secuencial retrospectiva. Se emplearon frecuencias, medidas de tendencia central y de dispersión. Se hizo un análisis de supervivencia libre de recaída locorregional, libre de enfermedad y global aplicando el método de Kaplan-Meyer y la regresión de Cox.

Resultados

se identificaron 174 pacientes en su mayoría con tumores ductales, con compromiso ganglionar y expresión de receptores hormonales. El tratamiento se realizó con quimioterapia, seguida de mastectomía, vaciamiento axilar, quimioterapia, radioterapia y hormonoterapia adyuvante en la mayoría de casos. La supervivencia libre de recaída locorregional a cinco años fue de 88.,8%, la supervivencia libre de enfermedad fue de 63,3% y la supervivencia global fue de 84,4%.

Conclusión

los datos de supervivencia libre de recaída locorregional son similares a los reportados en la literatura. La reconstrucción mamaria se asoció con un aumento en el peligro de recaída locorregional. La razón ganglionar fue un factor pronóstico relevante para supervivencia global, libre de enfermedad y libre de recaída local y regional, mientras que el grado tumoral fue un factor pronóstico relevante en supervivencia global y libre de enfermedad.

Palabras clave:

neoplasias de la mama

terapia combinada

mastectomía

radioterapia

análisis de supervivencia

Abstract

Objective

To evaluate survival after treatment with mastectomy and teletherapy for locally advance breast cancer at the National Cancer Institute of Colombia.

Methods

A case serie analysis was conducted. Frequencies and measures of central tendency were applied. Locoregional relapse free survival, disease free survival and overall survival were determined with Kaplan-Meyer and Cox regression analyses.

Results

174 patiens were included. Most of the patients corresponded to ductal tumors with positive axillary nodes and hormone receptors. The treatment was neoadjuvant chemotherapy, mastectomy, axillary nodes resection, radiotherapy, and adjuvant hormone therapy. The 5-years locoregional relapse free survival was 88.8%, disease free survival was 63.3%, and overall survival 84.4%.

Conclusions

The results are similar to previous reports. Breast reconstruction was associated with a greater chance of locoregional relapse. The node rate is a relevant predictor for overall survival, disease free survival, and locoregional relapse free survival, and tumor grade for the former two.

Key words:

Breast neoplasm

combined modality therapy

mastectomy

radiotherapy

survival analysis

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